Rosa Salinas
Houston
Summary
Detail-oriented Claims Examiner with expertise in claims assessment, policy interpretation, and negotiation. Proven ability to guide teams on compliance and effectively manage workloads to ensure timely claim processing. Dedicated Claims Examiner with 9+ years of experience in the insurance industry. Skilled in negotiating settlement terms and ensuring compliance with processing rules. Committed to leveraging comprehensive policy knowledge to enhance team performance and improve claim outcomes.
Overview
19
19
years of professional experience
Work History
Claims Examiner
Davis Law Firm
San Antonio
12.2010 - 12.2019
- Reviewed medical records to assess coverage eligibility for insurance claims.
- Executed data entry to update claim status within computer system.
- Gained comprehensive knowledge of company policies regarding claim processing and payment.
- Guided staff on claim processing rules and regulations to ensure compliance.
- Efficiently managed workloads by prioritizing tasks based on urgency.
- Negotiated settlement terms with claimants, adhering to authorized limits.
Claims Examiner
Tellez Law Group
San Antonio
03.2006 - 12.2010
- Reviewed medical records to assess coverage eligibility for insurance claims.
- Executed data entry to update claim status within computer system.
- Gained comprehensive knowledge of company policies regarding claim processing and payment.
- Guided staff on claim processing rules and regulations to ensure compliance.
- Efficiently managed workloads by prioritizing tasks based on urgency.
- Negotiated settlement terms with claimants, adhering to authorized limits.
Administrative Assistant
Laredo Bucks Hockey Holdings
Laredo
05.2004 - 05.2006
- Provided administrative support to the executive team, including scheduling meetings and managing calendars.
- Created travel arrangements and distributed travel details to appropriate personnel.
- Facilitated communication between different departments within the organization.
- Answered phone calls and emails to provide information, resulting in effective business correspondence.
- Coordinated and scheduled meetings, travel for players, including housing, passports, and the well-being of players.
Administrative Assistant
Reynor Inc.
Laredo
08.2000 - 06.2004
- Entered data into spreadsheets using Microsoft Excel or other similar programs.
- Conducted research on various topics as requested by management.
- Perform a variety of Internet research functions, and use word processing, spreadsheets, and presentation software.
- Schedule appointments, meetings, and travel itinerary.
- Perform other administrative duties, including distributing mail, and other duties as assigned.
Skills
- Claims assessment and policy interpretation
- Settlement negotiation and insurance expertise
- Problem solving and attention to detail
- Conflict resolution and team collaboration
Languages
English
Professional
Spanish
Professional
References
References available upon request.
Timeline
Claims Examiner
Davis Law Firm
12.2010 - 12.2019
Claims Examiner
Tellez Law Group
03.2006 - 12.2010
Administrative Assistant
Laredo Bucks Hockey Holdings
05.2004 - 05.2006
Administrative Assistant
Reynor Inc.
08.2000 - 06.2004
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